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    What causes mood swings, low libido, erectile dysfunction and high testosterone?

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Posted on Thu, 2 Jun 2016 in Thyroid Problem and Hormonal Problems
Question: Leaving out some things to get to the point. I have for about a year been going through mood swings, mostly emotional and weepy, I completely lost my sex drive a few months ago and now have ED.

I had my testosterone checked, it was in the low 400s. Five days ago I had testosterone pellets inserted, 2000 mgs. I have felt no change physically, but I think emotionally I'm a little bit more of a wreck than before. Also still no libido

Is it too early to tell what's going on? I am supposed to get my blood work drawn in a month after pellet insertion. I was thinking I would try to set it up 2 weeks early if I had no changes.

Could it be normal for my emotional symptoms to worsen with trt? I think I may be just anxious to feel better, but I thought I would be feeling better by now.
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Answered by Dr. Shehzad Topiwala 2 hours later
Brief Answer:
Testosterone

Detailed Answer:
I follow what you are saying here.

One of the consequences of high testosterone levels in the blood is a tendency to get aggressive. Anxiety is not known to occur as such.

Generally 1 month is a good time frame to pass before retesting for levels.

Moreover, another important question needs to be asked here. Do you truly have testosterone deficiency. Level of 400 is considered normal.
Of course, once can argue that this is Total Testosterone and so the more accurate indicator being Free Testosterone (done by a special method called Equilibrium Dialysis) needs to be done to be sure.

When I see someone like you in my practice, I typically order the following blood tests in addition to a detailed physical examination:

CBC (Complete Blood Count, also known as Hemogram; includes Hemoglobin, WBC and Platelet counts)
Electrolytes (Sodium and Potassium in particular)
HbA1c (Glycosylated Hemoglobin = your 3 month glucose average)
Liver function tests (SGOT , SGPT, Albumin, Bilirubin, Alkaline Phosphatase)
Kidney function tests (BUN, Creatinine)
TSH
25 hydroxy Vitamin D
Total Testosterone
SHBG (Sex Hormone Binding Globulin)

None of these tests require any fasting and can be done at any time of the day.

You would have to be off your pellets for several weeks before you can run these tests.
You will be best served by consulting an endocrinologist in-person.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Shehzad Topiwala

Endocrinologist

Practicing since :2001

Answered : 1663 Questions

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